RESUMEN
BACKGROUND: Preventing and reducing nosocomial infections is a public health goal. Concern about healthcare-associated fungal infections has increased in recent years due to the emergence and spread of new pathogens, increasing antifungal resistance and outbreaks in hospital settings. AIM: To investigate the presence of medically relevant fungal species on environmental surfaces in 12 intensive care units of eight hospitals in Milan, Italy. METHODS: Environmental samplings, using contact plates on surfaces near bed stations and medical workstations, were conducted between November 2019 and January 2020. Fungi isolated were identified, and some were tested in vitro for antifungal susceptibility. FINDINGS: In total, 401 environmental samples were collected from 61 bed stations and 17 medical workstations. Positive samples were found in all hospitals except one, with positivity rates ranging from 4% to 24.2%. Filamentous fungi were found mainly on infusion pumps (23.2%) and patient tables (21.2%), whereas yeasts were found mainly on computers (25%) and floors (10.9%). Fungi were isolated from 12% of total samples. Filamentous fungi, mainly Aspergillus fumigatus, grew in 70.8% of positive samples, and yeasts grew in 27.1%, mainly Candida parapsilosis (42.8%) and Candida glabrata (28.6%). Fungi were detected near patients' beds and on surfaces at workstations, indicating potential for environment-to-patient, patient-to-patient and healthcare worker-to-patient transmission. CONCLUSIONS: Surveillance in hospital settings through environmental sampling may be an important component of fungal infection prevention.
Asunto(s)
Infección Hospitalaria , Micosis , Antifúngicos/uso terapéutico , Infección Hospitalaria/tratamiento farmacológico , Infección Hospitalaria/epidemiología , Infección Hospitalaria/prevención & control , Farmacorresistencia Fúngica , Hongos , Humanos , Unidades de Cuidados Intensivos , Pruebas de Sensibilidad Microbiana , Micosis/epidemiología , Micosis/prevención & controlRESUMEN
BACKGROUND: Waiting time for outpatient specialist care is an ever-present problem for all Countries with a universal healthcare system. In Italy, information about waiting times must be available on all websites belonging to public health agencies and healthcare structures. The aim of the present descriptive study is to evaluate the accessibility and quality of such information on websites of all public health agencies and healthcare structures in Lombardy Region. METHODS: All websites belonging to 8 health agencies (ATS), 27 public hospitals (ASST), 4 research and teaching hospitals (IRCCS) were analyzed using a newly designed 30-item checklist. The items were scored 0/1 and grouped in five categories: Accessibility, Architecture, Content, Interactivity, Utility. RESULTS: In all, 76.3% of websites reported their waiting times directly, but three did not update data at least monthly as required by current legislation. Less than half of websites provided information aimed at raising awareness and tackling no-shows, and only 10.5% explained the role of private practice in public structures when maximum waiting times are exceeded. CONCLUSIONS: The lack of exposition of waiting times on some websites belonging to ATS, ASST and IRCCS appears to be a relevant issue. There is also little empowering information that may help tackle waiting times themselves. These results warrant further efforts to improve accessibility, quality and transparency of information for all citizens.
Asunto(s)
Salud Pública , Listas de Espera , Accesibilidad a los Servicios de Salud , Hospitales Públicos , Humanos , Pacientes AmbulatoriosRESUMEN
Triphenyltin is an organotin compound that has been used extensively as an antifouling biocide and as an agricultural pesticide. Certain organotin compounds act as endocrine-active agents and have been reported to affect reproduction in mollusks and mammals. Here we studied the histopathological effects of 2 or 6mg triphenyltin chloride (TPTCl)/kg b.w. on the reproductive tissue and the thymus of female pubertal rats as part of a comprehensive pubertal assay. Beginning at postnatal day (PND) 23 female Wistar rats were treated daily per gavage until their first estrus after PND 53. Reproductive organs were removed and histologically evaluated. While no histological changes were observed in oviduct, uterus, vagina and mamma, an increase in the number of all follicle stages occurred at both dose levels. Furthermore, exposure to 2mg TPTCl/kg b.w. led to a significant reduction in the diameter of tertiary follicles. A significant increase in the number of atretic follicles was observed in tertiary and preovulatory follicles after exposure to 6mg TPTCl. The thymus displayed a decreased number of apoptotic cells in both dose groups. We conclude that peripubertal administration of 2 and 6mg TPTCl/kg b.w. caused effects on ovarian follicles of female rats.
Asunto(s)
Antiinfecciosos/toxicidad , Compuestos Orgánicos de Estaño/toxicidad , Ovario/efectos de los fármacos , Ovario/patología , Animales , Femenino , Inmunohistoquímica , Ratas , Ratas Wistar , Timo/efectos de los fármacos , Timo/patologíaRESUMEN
Seven heroin addicts were treated with fluconazole for endophthalmitis. All the patients had cutaneous lesions: deep-seated scalp nodules and/or pustulosis in hairy zones. One patient had an abscess at the venipuncture site. Candida albicans was isolated from all the extraocular sites in all the patients. Five patients were treated with 400 mg of intravenous fluconazole on the first day, followed by 200 mg (i.v.) for one week and finally 200 mg daily orally for a further two weeks. Two patients were treated exclusively with oral fluconazole (400 mg on the first day, followed by 200 mg daily for three consecutive weeks). Tolerance to fluconazole was good and it was not necessary to stop treatment for any patient. All the cutaneous lesions stabilized and healed. The eye lesions cleared completely in all cases, except in one patient in whom vitrectomy was indicated, and in whom there was a poor response to the exclusive treatment with fluconazole and associated corticosteroids.